The number of heart transplants performed in Ohio fell last year to its lowest level since 1989 as more of the vital organs leave the state than come in.
Of the 155 people waiting for heart transplants in Ohio as of Feb. 7, 59 percent have been doing so for at least a year — the highest rate in the nation, The Columbus Dispatch reported.
In the past seven years at the Cleveland Clinic — which performed about two-thirds of the state's heart transplants last year — the transplant numbers have fallen from 76 to 44, or more than 40 percent.
Ohio State University's Comprehensive Transplant Center performed 10 heart transplants last year, about half of its peak of 19 in 2006. So far this year, it has performed two.
Meanwhile, heart transplants nationwide were on pace last year to increase and set an annual record by topping 2,500, according to the most recent statistics available.
The decreases in Ohio are the result of a 2006 policy change by the Organ Procurement and Transplantation Network that expanded regional organ sharing to reduce deaths among people waiting for transplants.
For Ohio, the policy change has made the state a net exporter of donor hearts since 2006, with the number of hearts leaving the state exceeding the number entering the state by more than 70. From 1991 to 2006, the state was a net importer, with the number of heart transplants exceeding the supply of hearts originating in Ohio by 460, or by 29 percent.
Surgeons at the Cleveland Clinic suspect that one reason for the decline in heart transplants involves the use of left-ventricular assist devices, implanted mechanical pumps that help keep patients alive while they wait for a heart transplant.
Years ago, complication risks from the devices were higher, and many patients receiving one were given priority status for heart transplants.
That priority status has benefited regions of the country where a higher proportion of transplant candidates have had the devices implanted, including parts of the East Coast within 500 miles of Ohio transplant centers, said Dr. Randall Starling, the Cleveland Clinic's head of cardiac transplant.
The declines in Ohio are worrisome, said Dr. Nader Moazami, the surgical director of cardiac transplantation and mechanical circulatory support at the Cleveland Clinic. For example, he said a heart recently donated in Columbus went to an out-of-state patient instead of to one in Cleveland. Before 2006, an Ohio resident would have gotten it.
But the notion that a heart should remain in the state where it is donated is antiquated, said Dorrie Dils, the chief clinical executive for Lifeline of Ohio, an organ-procurement agency that serves 37 counties in central and southeastern Ohio.
Organs are a national resource, and donors "just want to help someone," no matter where they live, Dils said.